CHEST Guidelines-Addressing-Emotional-Distress-in-Patients-With-Inc

Addressing-Emotional-Distress-in-Patients-With-Inc

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The article addresses the issue of emotional distress in patients with incidental pulmonary nodules (IPNs) and explores ways to improve adherence to clinical guidelines for managing these nodules. Over 1.5 million IPNs are detected annually in the U.S., and while they are mostly benign, proper evaluation according to guidelines is crucial since some IPNs may indicate early-stage lung cancer. The study by Gould et al. highlights that nearly half of the patients with newly detected IPNs experience significant emotional distress, anxiety, and worry about potential cancer risk.<br /><br />Patients were often informed of their IPNs via indirect means such as email or electronic health records, rather than through direct communication, which could elevate emotional distress levels. Notably, disparities were observed in the notification of IPNs, particularly among men, Black and Asian patients, and those with Medicaid or VA insurance, indicating a need for more equitable management approaches.<br /><br />The study underscores the importance of direct patient-provider communication to alleviate nodule-related distress and improve adherence to follow-up recommendations. Suggestions for mitigating distress include explaining the nature of nodules, assessing cancer risk, addressing potential anxieties, and providing accessible educational resources. Moreover, the lack of notification or inadequate patient-physician discussion was associated with poor understanding of surveillance plans and contributed to nonadherence.<br /><br />The article calls for system-level improvements to ensure appropriate nodule surveillance, emphasizing the importance of using available resources and education to maintain adherence to guidelines. It stresses the need for further research to explore strategies for addressing emotional distress in patients and understanding disparities in notification and management of IPNs. Addressing these issues could potentially improve patient outcomes and reduce the risk of late-stage diagnoses.

Keywords

emotional distress

incidental pulmonary nodules

clinical guidelines

early-stage lung cancer

patient-provider communication

health disparities

nodule surveillance

patient outcomes

cancer risk

nonadherence